Concussions that occur to athletes can take days if not weeks or months to recover. Many schools use different grading systems for assessment and different baseline tests for concussions, making it almost impossible to have a universal protocol for return to play. The NCAA and the NATA have both taken rather “grey” stances as well. They both leave some room for maneuvering and that is not always the best thing. The decision on when to return to play is ultimately made by the team physician based on neurological and cognitive function along with signs and symptoms presented by the athlete.
There have been many cases in which athletes have gone back to return to play status sooner than they should have; this could be due the lack of a standard protocol, but it also has many other factors including the amount of education the individual athletes receive about concussions by his or her medical staff or if they are being honest and reporting all of their symptoms. To prevent lack of education it is now required by NCAA member institutions to have athletes read and sign acknowledgements stating that they understand the signs and symptoms of a concussion and the elevated risks of a concussion for their specific sport.
To protect ourselves legally, the latest issue of the NATA News provided a great article on the legal issues surrounding athletic trainers and important things to consider when dealing with athletes in this litigious time. The issue also suggests recording specific tests and maneuvers performed, dates, times and specific locations of testing, and the questions asked of the athlete during testing and the athlete’s responses. The take home message that we have found is that it is better to treat concussions more conservatively than any other injury to reduce the risk of second impact syndrome, which could ultimately lead to death, and to minimize the effects of a traumatic brain injury later on in life. Also, it is important to always be cognizant to protect yourself as a healthcare provider, should a lawsuit ever be filed against you or your organization.
For more information on Concussions from a doctor’s standpoint check out:
Information from the NCAA
NATA Position Statement on Concussions